Paul J Jacquay, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

471 Issued in WY

Practice address

2508 E Fox Farm Rd Ste 1a
Cheyenne, WY 82007-2559

Phone

(307) 635-3618

Fax

(307) 635-1442

NPI assigned

Apr 15, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1053554402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 E FOX FARM RD STE 1A",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820072559",
            "telephone_number": "307-635-3618",
            "fax_number": "307-635-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 E FOX FARM RD STE 1A",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820072559",
            "telephone_number": "307-635-3618",
            "fax_number": "307-635-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUAY",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-15",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelynn Jackson
• Alec Jay Jacobs, DPT
• Alice M Jacobson, PA-C
• Sarah Christine Jacobson, RN
• Stephen G. Jacobson, MD
• Nevaeh Jacques
• Raja Shekar Rao Jadav, MD
• Kala James, PHARMD
• Kelsey Marie James, PHARMD
• Stephanie Anne James, LCSW

• Physician Assistant in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.